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Themes | Subthemes | Key findings |
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Being able to enhance patient-centered care and clinical practice during chemotherapy | Home-based community support allowed preemptive and individualized symptom management support | (i) CN home visits promoted preemptive symptom management through patient education |
(ii) CNs connected with relevant healthcare providers when issues arose |
(iii) CNs provided emotional support to the patient |
The benefit to clinicians’ practice by improving patient symptom monitoring during treatment and broadening clinical skill sets | (i) Oncologists were reassured knowing that clinically vulnerable patients receive CN support at home |
(ii) CNs could expand their skill set in cancer care |
(iii) C-SAS enabled oncologists to gain better insights into how their patients manage symptoms at home |
(iv) The intervention offered an opportunity for GPs to be engaged in care during chemotherapy treatment |
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The importance of effective communication and collaborative relationships between different care settings | The need for building collaborative relationships between cancer and community services | (i) Fostering collaborative relationships between cancer and community services was important and this could have been enhanced through clinical observership at the cancer center, face-to-face training, and mentoring during CN training |
Effective communication between healthcare providers was challenged by preexisting system barriers | (i) A communication gap existed between cancer services and general practices, requiring exploration for a more effective way of engaging with GPs |
(ii) The importance of shared electronic medical record (eMR) systems across different settings |
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Ways to adapt the intervention for implementation in routine clinical practice | Identifying patients who are in the greatest need of the intervention to optimize healthcare resource utilization | (i) Given limited resources, a risk- or need-based referral to CN support will be needed |
(ii) Potential groups could include those more prone to treatment toxicity, experiencing social isolation, dealing with disease-related symptoms, undergoing curative intent treatment, or receiving chemotherapy for the first time |
Needing flexibility in delivering the model | (i) The need for a more flexible approach, such as substituting some face-to-face visits with telephone calls or adjusting the timing of visits |
(ii) Needing the option for clinicians to exercise discretion in arranging CN support while allowing patients to opt in or out |
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